Active NPI
Richard S Stern, PHD
- Clinical Psychologist
- Philadelphia, PA
National Provider Identifier
1922406065
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- PS 015389
- Practice address
- 6833 Wayne Ave
Mount Airy Counseling Center
Philadelphia, PA 19119-3423 - Phone
- (215) 888-7785
- NPI assigned
- Dec 5, 2014
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | PS 015389 | PA | Primary |
| Clinical Child & Adolescent Psychologist | 103TC2200X | PS 015389 | PA |
Addresses
Primary practice location
6833 Wayne Ave
Mount Airy Counseling Center
Philadelphia, PA 19119-3423
Mailing address
6833 Wayne Ave
Mount Airy Counseling Center
Philadelphia, PA 19119
Phone (215) 888-7785
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PS 015389 | PA | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1417737600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1417737600000",
"number": "1922406065",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6833 WAYNE AVE",
"address_2": "MOUNT AIRY COUNSELING CENTER",
"city": "PHILADELPHIA",
"state": "PA",
"postal_code": "19119",
"telephone_number": "215-888-7785"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6833 WAYNE AVE",
"address_2": "MOUNT AIRY COUNSELING CENTER",
"city": "PHILADELPHIA",
"state": "PA",
"postal_code": "191193423",
"telephone_number": "215-888-7785"
}
],
"practiceLocations": [],
"basic": {
"last_name": "STERN",
"first_name": "RICHARD",
"middle_name": "S",
"name_prefix": "Dr.",
"credential": "PHD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2014-12-05",
"last_updated": "2014-12-05",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "PA",
"license": "PS 015389",
"primary": true
},
{
"code": "103TC2200X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical Child & Adolescent",
"state": "PA",
"license": "PS 015389",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Philadelphia, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.